Surgical management of femoral artery pseudoaneurysms secondary to drug abuse.

OBJECTIVE: To assess the outcome of surgical management of mycotic false aneurysms due to local injury after intravenous injection of drugs.

STUDY DESIGN: Case series.

PLACE AND DURATION OF STUDY: Department of Surgery, Kerman Medical School of Sciences, Kerman, Iran, from July 2001 to June 2009.

METHODOLOGY: Twenty one consecutive patients presenting with infected femoral artery pseudoaneurysms (IFAPs) secondary to parenteral drug abuse treated in our department were studied. Data analyzed included demographic characteristics, modes of presentation, side of involvement, management and outcome.

RESULTS: All patients were male with mean age of 32.2 ± 5.2 years. All presented with pain and swelling in the groin. Five patients presented with significant hemorrhage. The locations were the left side in 9 cases and the right side in 12 cases. The injured artery was the common femoral artery and its bifurcation. In 14 patients (64%), ligation-excision was carried out. In 5 patients (26%), primary repair of the artery with over-sewing was done. In 2 patients (10%), revascularization with saphenous interposition was carried out. Below-knee amputation was necessary in 1 patient who underwent ligationexcision. One patient died due to severe septicemia.

CONCLUSION: Ligation of IFAPs is an effective, safe and simple option. Primary repair with preservation of the native vessel is suggested if infection is limited.